Does managed care affect interagency linkages? Some literature suggests that managed care weakens relationships among providers. Literature also shows that substance abuse services are most effective for persons with both mental health and substance abuse disorders if they receive services for both disorders concomitantly. Managed care, with its practices of decreasing service use and defining provider networks, may disrupt the local service system of care. Conversely, managed care may shape a service system through mandated central referring and provider networks. This study seeks to determine how managed care penetration in a market is related to the number and strength of service linkages between substance abuse, mental health and primary care providers. The study uses data from approximately 420 service providers in 60 sites across the US. At each site, one outpatient substance abuse organization is interviewed along with up to six other local providers of mental health and primary care which comprise the service network. The data describe attributes of each organization, their clients, and the extent to which they receive and are affected by managed care financing arrangements. Preliminary data suggest that a minority of clients are involved in service relationships and that these provider linkages are informal and infrequent. Rather than disrupting systems of care, it may be that managed care provides incentives for those systems to take on certain forms. Implications for mental health policy and practice will be highlighted.
Learning Objectives: 1. Describe service linkages between substance abuse, mental health and primary care providers. 2. Assess the impacts of managed care on the above service linkages.
Keywords: Managed Care, Network Analysis
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